Helical tomotherapy will ultimately replace linear accelerator based IMRT as the best way to deliver conformal radiotherapy

Bichay, T; Cao, D.; Orton, Colin G.

doi:10.1118/1.2885365

Cited by 12 publications

(11 citation statements)

References 21 publications

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“…This can result in loss of useful directions prior to the initiation of optimization. In tomotherapy and VMAT, the optimizer can have full access to 360 degrees of rotation 32 .…”

Section: Discussion: Comparing Fixed Gantry Imrt Tomotherapy and Vmatmentioning

confidence: 99%

“…Similarly fixed gantry IMRT techniques are also capable of delivering non-coplanar fields. For some intracranial and head and neck tumours, the use of non-coplanar arcs can provide significant dosimetric benefits due to preferential sparing of adjacent sensitive structures 32 . Supporters of tomotherapy would argue that range of beam angles possible using fixed gantry IMRT or VMAT is limited by the need to avoid collision between the linac head with the patient or couch.…”

Section: Discussion: Comparing Fixed Gantry Imrt Tomotherapy and Vmatmentioning

confidence: 99%

“…Tomotherapy is not capable of delivering noncoplanar fields. However, tomotherapy employs hundreds of thousands of beamlets which can overcome much of this limitation, even in very complex targets adjacent to sensitive structures 32 .…”

Section: Discussion: Comparing Fixed Gantry Imrt Tomotherapy and Vmatmentioning

confidence: 99%

See 2 more Smart Citations

An Introduction to the Intensity-modulated Radiation Therapy (IMRT) Techniques, Tomotherapy, and VMAT

Elith

Dempsey

Findlay

et al. 2011

Journal of Medical Imaging and Radiation Sciences

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“…This can result in loss of useful directions prior to the initiation of optimization. In tomotherapy and VMAT, the optimizer can have full access to 360 degrees of rotation 32 .…”

Section: Discussion: Comparing Fixed Gantry Imrt Tomotherapy and Vmatmentioning

confidence: 99%

Section: Discussion: Comparing Fixed Gantry Imrt Tomotherapy and Vmatmentioning

confidence: 99%

See 1 more Smart Citation

An Introduction to the Intensity-modulated Radiation Therapy (IMRT) Techniques, Tomotherapy, and VMAT

Elith

Dempsey

Findlay

et al. 2011

Journal of Medical Imaging and Radiation Sciences

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“…With the introduction of helical tomotherapy, many people believed that it would ultimately replace linac-based IMRT [ 27 ] as it provided highly conformal dose distributions. In this spirit, a tomotherapy-mimicking IMRT using linac IMAT was proposed by Yu [ 28 ].…”

Section: Development Of Imrtmentioning

confidence: 99%

Intensity-modulated radiation therapy: a review with a physics perspective

Cho

2018

Radiat Oncol J

105

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Intensity-modulated radiation therapy (IMRT) has been considered the most successful development in radiation oncology since the introduction of computed tomography into treatment planning that enabled three-dimensional conformal radiotherapy in 1980s. More than three decades have passed since the concept of inverse planning was first introduced in 1982, and IMRT has become the most important and common modality in radiation therapy. This review will present developments in inverse IMRT treatment planning and IMRT delivery using multileaf collimators, along with the associated key concepts. Other relevant issues and future perspectives are also presented.

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“…In the evaluation studies, a 256-field IMRT plan is used instead due to the fact that it corresponds well with EGRT's 256-firingposition geometry enabling a direct comparison and provides a good approximation of a VMAT plan. Since the EGRT helical dose delivery geometry provides more degrees of freedom due to the large number of fields used, 48 EGRT possesses increased flexibility in planning a treatment compared with a conventional step-and-shoot IMRT treatment. Highly efficient IMRT planning methods tailored for EGRT delivery that make full use of such flexibility can be developed to improve EGRT's performance.…”

Section: Discussionmentioning

confidence: 99%

Toward a planning scheme for emission guided radiation therapy (EGRT): FDG based tumor tracking in a metastatic breast cancer patient

et al. 2013

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Purpose: Emission guided radiation therapy (EGRT) is a new modality that uses PET emissions in real-time for direct tumor tracking during radiation delivery. Radiation beamlets are delivered along positron emission tomography (PET) lines of response (LORs) by a fast rotating ring therapy unit consisting of a linear accelerator (Linac) and PET detectors. The feasibility of tumor tracking and a primitive modulation method to compensate for attenuation have been demonstrated using a 4D digital phantom in our prior work. However, the essential capability of achieving dose modulation as in conventional intensity modulated radiation therapy (IMRT) treatments remains absent. In this work, the authors develop a planning scheme for EGRT to accomplish sophisticated intensity modulation based on an IMRT plan while preserving tumor tracking. Methods:The planning scheme utilizes a precomputed LOR response probability distribution to achieve desired IMRT planning modulation with effects of inhomogeneous attenuation and nonuniform background activity distribution accounted for. Evaluation studies are performed on a 4D digital patient with a simulated lung tumor and a clinical patient who has a moving breast cancer metastasis in the lung. The Linac dose delivery is simulated using a voxel-based Monte Carlo algorithm. The IMRT plan is optimized for a planning target volume (PTV) that encompasses the tumor motion using the MOSEK package and a Pinnacle 3TM workstation (Philips Healthcare, Fitchburg, WI) for digital and clinical patients, respectively. To obtain the emission data for both patients, the Geant4 application for tomographic emission (GATE) package and a commercial PET scanner are used. As a comparison, 3D and helical IMRT treatments covering the same PTV based on the same IMRT plan are simulated. Results: 3D and helical IMRT treatments show similar dose distribution. In the digital patient case, compared with the 3D IMRT treatment, EGRT achieves a 15.1% relative increase in dose to 95% of the gross tumor volume (GTV) and a 31.8% increase to 50% of the GTV. In the patient case, EGRT yields a 15.2% relative increase in dose to 95% of the GTV and a 20.7% increase to 50% of the GTV. The organs at risk (OARs) doses are kept similar or lower for EGRT in both cases. Tumor tracking is observed in the presence of planning modulation in all EGRT treatments. Conclusions: As compared to conventional IMRT treatments, the proposed EGRT planning scheme allows an escalated target dose while keeping dose to the OARs within the same planning limits. With the capabilities of incorporating planning modulation and accurate tumor tracking, EGRT has the potential to greatly improve targeting in radiation therapy and enable a practical and effective implementation of 4D radiation therapy for planning and delivery.

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Helical tomotherapy will ultimately replace linear accelerator based IMRT as the best way to deliver conformal radiotherapy

Cited by 12 publications

References 21 publications

An Introduction to the Intensity-modulated Radiation Therapy (IMRT) Techniques, Tomotherapy, and VMAT

An Introduction to the Intensity-modulated Radiation Therapy (IMRT) Techniques, Tomotherapy, and VMAT

Intensity-modulated radiation therapy: a review with a physics perspective

Toward a planning scheme for emission guided radiation therapy (EGRT): FDG based tumor tracking in a metastatic breast cancer patient

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